The shoulder is one of the largest and most complex joints in the body. The shoulder normally has a wide range of motion, but because of it’s flexibility and complexity, it tends to also be easily injured.
The shoulder is a ball and socket joint made up of two main bones: the upper arm bone (humerus) and the shoulder blade (scapula). Above the ball and socket joint, is another bone called the acromion. Next to the acromion is the “AC joint” where the acromion meets a third bone, the clavicle. This is a common place for shoulder separations. The rotator cuff is a group of 4 muscles that help move your shoulder joint. These muscles work together to help raise your arm over your head, rotate your arm in and out and also function to help keep your shoulder located or in socket. There are several ligaments and tendons in the shoulder and also what is known as the “O-ring”, or labrum. Both the ligaments and labrum assist in keeping your shoulder in socket. Ligaments connect the bones of the shoulders and the tendons connect bones to surrounding muscle.
Diagnosis of your shoulder injury or condition will begin with a discussion of your health history and a physical examination. X-ray and MRI diagnostic testing may also be needed to confirm a diagnosis or eliminate possibilities before a course of treatment can be decided between you and the doctor. Both non-surgical and surgical options will be discussed prior to proceeding with your individualized treatment plan. Many of the conditions or injuries that require operative care can be accomplished through arthroscopy or minimally invasive surgeries.
Common Shoulder Injuries
Rotator Cuff Tears
A tear in the rotator cuff is the separation of the tendons in the joint from the bone. It is not an uncommon injury and occurs in people of all ages. However, it usually occurs in individuals over 40 who engage in repeated overhead movements from sports, work or daily life activities.
The shoulder is one of the most commonly dislocated joints. Instability means that the shoulder can dislocate (be pulled out of joint) or experience subluxation (move more than it should).
A dislocated shoulder occurs when the ball of the upper arm bone comes out of the shoulder socket. This disables the shoulder joint causing a considerable amount of pain. It is usual for the joint to dislocate forwards and downwards, but sometimes it may dislocate backwards.
Shoulder Arthroplasty (Shoulder Replacement)
Total shoulder arthroplasty (TSA), often called a total shoulder replacement is a surgical procedure in which part or all of the shoulder joint is replaced. Such joint replacement surgery generally is conducted to relieve arthritis pain or fix severe physical joint damage.
Impingement syndrome is a common condition affecting the shoulder often seen in aging adults. This condition is closely related to shoulder bursitis and rotator cuff tendonitis. These conditions may occur alone or in combination.
Bursitis is inflammation of the bursa, a small sac of fluid that sits under the highest point of your shoulder to cushion the joint and help it move easily. You can get bursitis by overusing your shoulder, which can happen with activities such as lifting, pitching a ball, or painting.
Shoulder tendonitis is the inflammation of the tendons around the shoulder”s rotator cuff and upper bicep area. Shoulder tendonitis is usually developed by sports and activities that require you to lift your hands above your head repeatedly. A common activity that can lead to shoulder tendonitis is strength training.
Clavicle Fracture (Broken Collarbone)
Clavicle fracture or broken collarbone is a the most commonly fractured bone in the human body. It is associated with high energy sports such as rugby, martial arts, cycling and motorbike riding. A direct blow over the shoulder or fall on an outstretched arm may also cause the clavicle bone to break.
Frozen shoulder is also called adhesive capsulitis. It typically affects patients between the ages of 40 to 60 years old, and occurs in approximately 2% of the population; however, it is more common in patients with other medical conditions such as diabetes, thyroid disease and cardiac problems.
Bankart Lesion (Torn Labrum)
A labrum tear is a common shoulder injury which can result from athletic activity, overuse, or the aging process. Labrum repair surgery is typically prescribed when non-surgical methods are ineffective for treating this condition.
Biceps Tendon Rupture
The bicep muscle plays a crucial role in the ability to help lift, rotate and move your upper arm. Located on the front of the upper arm just under the shoulder, the muscles are attached to the elbow and shoulder with bicep tendons, Sports injuries, overuse, falls, or wear and tear can cause a tendon rupture.
An acromioclavicular joint separation (AC separation), or shoulder separation, is a very frequent injury among active people, especially football or hockey players, and cyclists who fall over their handlebars. This injury occurs when the collarbone (clavicle) separates from the shoulder blade.
SLAP Lesion Tears
SLAP lesion (Superior Labral Anterior to Posterior tear) can occur from trauma, such as falling on your arm, bracing your arm in an accident, arm tackling in football or any large sudden force applied to the arm, causing a rip in the ligaments from front to back.
Sprains & Strains
The terms “sprain” and “strain” are often used interchangeably, but they actually refer to two different injuries. A strain refers to a stretching or tearing of a tendon or muscle, while a sprain is a stretching or tearing of a ligament. Most shoulder injuries are sprains.